How much rates vary
Facilitymedian $1,660 · 10th to 90th $288 to $6,607Professionalmedian $339 · 10th to 90th $245 to $501
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,621.81 Median $4,466.84 Typical High $7,244.36 | Facility | None | $1,621.81 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $269.15 Typical High $398.11 | Professional | None | $199.53 | $269.15 | $398.11 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,412.54 Median $2,630.27 Typical High $7,413.10 | Facility | None | $1,412.54 | $2,630.27 | $7,413.10 |
BCBS Idaho Setting Professional Modifier None Typical Low $275.42 Median $380.19 Typical High $602.56 | Professional | None | $275.42 | $380.19 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $2,089.30 | Facility | None | $1,380.38 | $1,548.82 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $288.40 Typical High $407.38 | Professional | None | $218.78 | $288.40 | $407.38 |
Moda Health Setting Facility Modifier None Typical Low $229.09 Median $398.11 Typical High $5,623.41 | Facility | None | $229.09 | $398.11 | $5,623.41 |
Moda Health Setting Professional Modifier None Typical Low $269.15 Median $338.84 Typical High $501.19 | Professional | None | $269.15 | $338.84 | $501.19 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $275.42 Median $288.40 Typical High $478.63 | Facility | None | $275.42 | $288.40 | $478.63 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $549.54 | Professional | None | $288.40 | $338.84 | $549.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,570.88 Median $6,606.93 Typical High $9,332.54 | Facility | None | $4,570.88 | $6,606.93 | $9,332.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $501.19 | Professional | None | $275.42 | $346.74 | $501.19 |
Select Health Setting Facility Modifier None Typical Low $263.03 Median $269.15 Typical High $3,630.78 | Facility | None | $263.03 | $269.15 | $3,630.78 |
Select Health Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $331.13 | Professional | None | $263.03 | $263.03 | $331.13 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $194.98 Median $275.42 Typical High $416.87 | Professional | None | $194.98 | $275.42 | $416.87 |
19 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $131.83 Median $131.83 Typical High $199.53 | Professional | 52 · Reduced service | $131.83 | $131.83 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $79.43 | Professional | 53 · Discontinued | $53.70 | $53.70 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $199.53 Typical High $295.12 | Professional | 54 · Surgery only | $199.53 | $199.53 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $60.26 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $39.81 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $186.21 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $186.21 | $186.21 | $275.42 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $398.11 Typical High $562.34 | Professional | 54 · Surgery only | $257.04 | $398.11 | $562.34 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $36.31 Typical High $57.54 | Professional | 55 · Aftercare only | $28.84 | $36.31 | $57.54 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $363.08 Median $436.52 Typical High $691.83 | Professional | 63 · Small infant | $363.08 | $436.52 | $691.83 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $309.03 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $213.80 | $309.03 | $436.52 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $131.83 Median $131.83 Typical High $199.53 | Professional | 52 · Reduced service | $131.83 | $131.83 | $199.53 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $79.43 | Professional | 53 · Discontinued | $53.70 | $53.70 | $79.43 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $199.53 Typical High $295.12 | Professional | 54 · Surgery only | $199.53 | $199.53 | $295.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $60.26 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $60.26 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $39.81 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $39.81 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $186.21 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $186.21 | $186.21 | $275.42 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $208.93 Typical High $309.03 | Professional | 54 · Surgery only | $208.93 | $208.93 | $309.03 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $43.65 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $43.65 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $223.87 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $223.87 | $223.87 | $331.13 |
Where Idaho sits
The same service costs 9.3 times more in Colorado than in Montana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
CO $5,912MT $637
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.